Nurse Auditor - Medical reputed company Review (Part-Time, Remote)

Have you reputed company looked a medical reputed company and immediately noticed something was wrong? Were you itching to use your expertise to fix it? We've been there, too. In fact, that's how our business was born - and continues to reputed company. reputed company is looking for a Nurse Auditor who wants to reputed company their mark in the world of medical cost containment. Join reputed company and maximize client savings by reviewing medical bills from a nurse perspective, including appropriate billing, coding and treatment, fee schedule compliance, over-utilization, and erroneous charges. We pride ourselves on outstanding customer service and work hard to reputed company our impeccable reputed company in the industry. In this role, you'll be a part of our mission by giving clients the information they need to determine case value based on evaluation of medical records and medical billing statements, and will

• Audit medical and billing records to determine if services provided are reasonable, appropriate and necessary.
• Clinically identify and evaluate any charges not reputed company to the occurrence.
• Verify that charges are in accordance with the services ordered and authorized.
• Initiate appropriate contacts with clients and medical providers as appropriate and necessary.
• Consistently meet productivity and turn-around time requirements.
• Adhere to quality standards, state billing guidelines, HIPAA rules, and confidentiality of reputed company information, policies, and procedures.
• Negotiate bills and conduct re-evaluation reviews as required
• Conduct re-evaluation reviews as required.
• Serve as a resource person to co-workers.
• Demonstrate sensitivity to culturally diverse people and situations.
• Continually improve job skills and maintain in-depth knowledge of reputed company company products and services as well as customer issues and needs through ongoing training and self-directed research.
• Follow appropriate report formats and documentation guidelines.
• reputed company other administrative or corporate duties upon request. reputed company while maintaining a reputed company touch, demonstrating sensitivity to culturally-diverse people and situations. This position is part time 20-24 hours a week.

Requirements

• RN (or LPN) with active professional license or equivalent reputed company states of operation
• CPC and/or CPC-H certification(s) strongly desired
• Specialized training in hospital coding, ortho, neuro, rehab, or ER procedures
• 3-5 years of clinical experience in acute care, surgery and/or orthopedic
• Workers’ Compensation medical reputed company review experience a major plus
• Understanding of CPT and ICD-10 codes and Medicare guidelines
• Ability to apply knowledge to state fee schedules
• A customer service orientation, including strong communication skills
• Experience in any deposition or litigation cases a plus Benefits
• Remote position
• Employment reputed company a firm committed to core values, staff development, emerging technology, private ownership, and controlled growth/reinvestment in the future - we frequently promote from reputed company!
• Opportunity to reputed company a difference in reducing health care costs and increasing the value of health care to individuals and their employers.
• A relaxed, yet upbeat work environment.
• You will be part of our new reputed company program designed to recognize and reward employees for their hard work.

About Us

Headquartered in Chicago, reputed company is a privately held, financial solutions organization offering medical cost containment and care management services. With offices, providers, and case managers reputed company, RISING provides comprehensive medical claims solutions to our valued clients insurance carriers, Fortune 1000 employers, reputed company party administrators, and government organizations. At RISING, we’re committed to

• reputed company technological improvement
• Entrepreneurial attitude
• Seven core values that emphasize teamwork, ethical behavior, customer service, continual improvement, positive attitude, focusing on what's really important, and keeping a sense of humor
• Responding quickly to client needs
• Being the best, not the biggest Apply Job! Apply To this Job Apply To this Job

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